Dealing with ICD-10-related payment delays
No matter how prepared your practice is, some payment delays due to the ICD-10 coding transition will happen. Here's how to keep them under control.
After years of stern warnings and friendly guidance, most practices did a good job of preparing for the new ICD-10 coding system, with adequate training and a financial cushion to tide them over in the case of delayed payments in the early stages. But some payment delays are inevitable, and smart practices will have a plan for dealing with them.
"We don't have a lot of feedback yet," said Robert Wergin, MD, president of the American Academy of Family Physicians, "but practices need to stay on top of claims—problems can add up quickly."
Wergin recommends having a system for tracking denials and queries so that you can find out why your claims are being rejected and correct any problems promptly. "Is it a coding problem? A workers' compensation issue? Problems with the individual's policy? Locate the mistake, correct it, and resubmit" Wergin says.
It doesn't stop there, though. "After you've found what the mistake was, find the source of the problem and make sure it doesn't happen again," Wergin said. It could be a physician not giving enough information to a coder, a coder not using the proper codes, or you may have missed a change in policy on the part of a payer. If you don't find out why your claims are bouncing back, it will just keep happening.
The longer you wait to correct and resubmit, of course, the longer it will take for your practice to get payment, delays that can hurt your bottom line and possibly cause you to have to draw on your credit or dip into your cash reserve. If you wait too long, you may not get paid at all. Filing deadlines vary from payer to payer, and if you miss them, you're out of options.
"You're busy—everyone's busy—and it's hard to pay attention to little claims," Wergin said, "but little claims add up fast; Stay on top of the remittance process. If you do, you may not have to dip into those reserve funds."